Classifications

• • A—HUMAN NECESSITIES
  • A01—AGRICULTURE; FORESTRY; ANIMAL HUSBANDRY; HUNTING; TRAPPING; FISHING
  • A01N—PRESERVATION OF BODIES OF HUMANS OR ANIMALS OR PLANTS OR PARTS THEREOF; BIOCIDES, e.g. AS DISINFECTANTS, AS PESTICIDES OR AS HERBICIDES; PEST REPELLANTS OR ATTRACTANTS; PLANT GROWTH REGULATORS
  • A01N35/00—Biocides, pest repellants or attractants, or plant growth regulators containing organic compounds containing a carbon atom having two bonds to hetero atoms with at the most one bond to halogen, e.g. aldehyde radical
  • A01N35/02—Biocides, pest repellants or attractants, or plant growth regulators containing organic compounds containing a carbon atom having two bonds to hetero atoms with at the most one bond to halogen, e.g. aldehyde radical containing aliphatically bound aldehyde or keto groups, or thio analogues thereof; Derivatives thereof, e.g. acetals
• • A—HUMAN NECESSITIES
  • A01—AGRICULTURE; FORESTRY; ANIMAL HUSBANDRY; HUNTING; TRAPPING; FISHING
  • A01N—PRESERVATION OF BODIES OF HUMANS OR ANIMALS OR PLANTS OR PARTS THEREOF; BIOCIDES, e.g. AS DISINFECTANTS, AS PESTICIDES OR AS HERBICIDES; PEST REPELLANTS OR ATTRACTANTS; PLANT GROWTH REGULATORS
  • A01N31/00—Biocides, pest repellants or attractants, or plant growth regulators containing organic oxygen or sulfur compounds
  • A01N31/02—Acyclic compounds
• • A—HUMAN NECESSITIES
  • A01—AGRICULTURE; FORESTRY; ANIMAL HUSBANDRY; HUNTING; TRAPPING; FISHING
  • A01N—PRESERVATION OF BODIES OF HUMANS OR ANIMALS OR PLANTS OR PARTS THEREOF; BIOCIDES, e.g. AS DISINFECTANTS, AS PESTICIDES OR AS HERBICIDES; PEST REPELLANTS OR ATTRACTANTS; PLANT GROWTH REGULATORS
  • A01N37/00—Biocides, pest repellants or attractants, or plant growth regulators containing organic compounds containing a carbon atom having three bonds to hetero atoms with at the most two bonds to halogen, e.g. carboxylic acids
  • A01N37/02—Saturated carboxylic acids or thio analogues thereof; Derivatives thereof

Definitions

• This invention is an improvement over my U.S. Patent 5,863,547 dated January 26, 1999 . It newly discovers that the addition of both alcohol and acetate salts are necessary for a glutaraldehyde high-level disinfectant to kill mycobacteria (TB), Gram-positive and Gram-negative vegetative bacteria, fungi, and viruses within 10 min at 20 C. Furthermore the fumes of glutaraldehyde are significantly suppressed by the alcohol and acetate salts combination. As a result, more rapid kill and less fumes are achieved for an improved glutaraldehyde-based formulation for the high-level disinfection and/or sterilization of heat-sensitive medical, dental, and veterinary reusable devices.
• Many medical devices are constructed of heat-sensitive polymeric materials, glues, glass lenses, and electronic components. Examples of such devices are gastroscopes, colonoscopes, cystoscopes, arthroscopes, transesophageal and vaginal probes, and anesthesia and respiratory therapy equipment. These heat-sensitive devices are very expensive, and thus are typically reused from one patient to another, and cannot be sterilized by steam or dry heat. These heat-sensitive devices are therefore disinfected with the highest levels of liquid chemical disinfectants.
• High-level disinfectants are able to kill Gram-positive and Gram-negative vegetative bacteria, mycobacteria such as Mycobacterium tuberculosis, fungi, and all types of viruses, with a relatively short exposure, and can also kill high numbers of bacterial spores dried onto surfaces with a much longer exposure time.
• the high-level disinfectant chemistries that are available for disinfecting medical devices are glutaraldehydes, other aldehydes such as ortho-phthalaldehyde and formaldehyde, peracetic acid, hypochlorous acid, and chlorine dioxide. These chemistries all have serious limitations as high-level disinfectants.
• Glutaraldehyde requires about 45 min at 25 C to kill 6 log 10 of mycobacteria, and about 10.0 hrs at 25 C to kill bacterial spores as measured by the Association of Official Analytical Chemists (AOAC) Sporicidal Test 966.04. These are impractical exposure times and temperatures that are often arbitrarily decreased in practice.
• Glutaraldehyde has a serious odor and sensitization problem that requires special equipment for fume containment and exhaustion.
• Formaldehyde is a known carcinogen with a noxious odor.
• Ortho-phthaladehyde has vapors that are relatively odorless, but the vapors can sensitize patients and staff. Some patients and staff have become sensitized to ortho-phthaladehyde, and reacted with anaphylactic shock to repeated exposure to fumes they could not smell.
• Ortho-phthaladehyde requires about 32 hrs to kill bacterial spores in the AOAC Sporicidal Test 966.04.
• Ortho-phthaldehyde is relatively insoluble, and thus difficult to rinse from surfaces.
• the aldehydes may be used and reused for typically 14 to 30 days.
• Peracetic acid has a sharp odor that must be contained within a machine, and the product is used with a temperature of 50 C to 56 C.
• the combination of the oxidative peracetic acid used at the relatively high temperature of 50 C to 56 C can be damaging to some glues and polymeric materials. All of the oxidative chemistries such as peracetic acid, hypochlorous acid, and chlorine dioxide are unstable and thus are single- or day- use products.
• the pH-value of the un-activated glutaraldehyde solution increased to about 6.5
• the stable pH-value for glutaraldehyde is about pH 3.5 to 4.5.
• the glutaraldehyde concentration of the un-activated formulation slowly decreased over a period of about 9 to 12 months of warehouse storage.
• This invention describes a high-level disinfectant formulation that can disinfect heat-sensitive medical devices quickly, for example within 10.0 min at ambient temperature, and as well has detectable, but relatively low, fumes of glutaraldehyde.
• the formula contains glutaraldehyde (2.0% to 5.0%), plus alcohol (5% to 26%), plus acetate salts (3% by weight to 8% by weight), all buffered at the time of use with an alkaline buffer system to pH-value 7.3 to 7.9. This stabilizes the glutaraldehyde over a 14-day period of use and reuse.
• the worst-case concentrations of this formula can kill bacterial spores as measured by the AOAC Sporicidal Test 966.04 within 6.0 hrs at 20 C.
• Glutaraldehyde is the first ingredient of the composition and may be present in the initial amount of between about 2.0% and 5.0% by volume. Unless specified otherwise the ranges of percent herein expressed are by volume.
• the starting concentration of the glutaraldehyde is 3.5% by volume so that the glutaraldehyde concentration can remain at or above 2.0% during storage and use and re-use for 14 days.
• the acetate salts will increase the storage pH value of the formulation to about 6.5.
• Glutaraldehyde is most stable at a pH value of about 3.5 to 4.5. During warehouse storage over a period of about 12 months at pH 6.5, the glutaraldehyde concentration will gradually decrease. Thus it is necessary to start with the higher concentration of glutaraldehyde to maintain effective minimum concentrations after warehouse storage and 14 days of use and re-use.
• Glutaraldehyde provides the primary antimicrobial activity of the composition.
• Alcohol is the second ingredient of the composition.
• Appropriate alcohols for use in the present invention are straight and branched chain water miscible alcohols, including methanol, ethanol, and isopropranol, as well as others. Isopropanol and ethanol are preferred.
• the alcohol is present in a concentration of between about 5% to about 26% by volume.
• the preferred alcohol concentration is 24-26% by volume.
• This alcohol concentration greatly enhances the tuberculocidal activity of for example to 2.0% glutaraldehyde.
• Alcohol alone is not tuberculocidal at 5% to 20% by volume, nor is 2.0% glutaraldehyde tuberculocidal at 20°C within a practical exposure time of 10 min.
• 5.0% to 26% by volume alcohol in combination with for example 2.0% glutaraldehyde is rapidly tuberculocidal within 10 min. at 20°C.
• Further enhancement of the tuberculocidal activity of glutaraldehyde with acetate allows the concentration of glutaraldehyde in the formula to be lowered.
• Isopropyl alcohol is the preferred second ingredient of the composition, and may be present in the preferred initial amount of between 24% and 26% by volume.
• the isopropyl alcohol will remain stable during warehouse storage. When the disinfectant is used and reused for 14 days, some alcohol will evaporate, and some alcohol will be inadvertently diluted as wet equipment carries water into the disinfectant, and the freshly disinfected equipment will carry alcohol to be rinsed away. It is therefore necessary to start with for example about 26% initial volume of alcohol in order to have at least 15% alcohol after 14 days of use and re-use of the disinfectant.
• the preferred isopropyl alcohol in combination with acetate salts greatly enhances the tuberculocidal activity of glutaraldehyde and the alcohol also suppresses the foaming of the composition, as would otherwise occur from the added surfactant.
• Acetate salts preferably potassium or sodium acetate salts are the third ingredient of the composition, and may be present initially at about 3% by weight to 8% by weight.
• the acetate salts are stable during warehouse storage. It is necessary to start with about 8% acetate salts by weight in order to have at least 5%, the preferred minimum effective level after use and re-use of the disinfectant for 14 days.
• the acetate salts in combination with the alcohol greatly enhance the tuberculocidal activity of the glutaraldehyde.
• the acetate salts also enhance the sporicidal activity of the composition.
• the acetate salts plus the alcohol surprisingly also suppress the fumes of glutaraldehyde which is of course desirable.
• a buffer preferably phosphate buffer
• Glutaraldehyde is stable in this composition buffered to about pH 7.3 to 7.9 for about 14 days during use and re-use. Buffers other than phosphate salts cause about a 40% decrease in the glutaraldehyde concentration of disinfectants activated with, for example, bicarbonate buffers. As a result, phosphate is preferred. It is of value to the composition to have the activated glutaraldehyde concentration remain stable during 14 days of use and re-use. This chemical stability during the 14 days of use and re-use provides more glutaraldehyde for antimicrobial activity at any given time than if the composition had been buffered with another buffer.
• the amount of buffer is from 4 g/liter to 7 g/liter.
• a surfactant in the preferred composition, as in the composition of my previous patent, there is a surfactant.
• the preferred surfactant levels are .0025% by weight to .01% by weight.
• Suitable surfactant is not critical and basically the same surfactants may be used as are listed in my prior patent which is incorporated herein by reference.
• this combination of glutaraldehyde at 2% to 5%, alcohol at 5% to 26%, acetate salts at 3% by weight to 8% by weight, a low-foaming, non-ionic surfactant at 0.0025% to 0.01% by weight activated with a phosphate buffer provides a high-level disinfectant that kills all non-spore-forming microbes within 10.0 min at ambient temperature, kills bacterial spores dried onto surfaces with their culture medium within 6.0 hrs at ambient temperature, has a non-offensive, yet noticeable and thus safely avoided, odor, and can be used safely and economically with heat-sensitive equipment for up to 14 days. It therefore accomplishes the invention objectives.
• a typical formulation of this invention was mixed and is as follows: Glutaraldehyde to 3.2% by volume Isopropanol 26% by volume Non-ionic surfactant .01% by weight Na 2 HPO 4 buffer 7.4 pH Acetate 8% by weight Water remainder
• CFU colony forming units
• Fresh Mycobacterium bovis var . BCG was obtained within twelve months of this test. Cultures of M. bovis var . BCG were grown on M7H9 agar slants in 25x250 mm screw-capped test tubes for 21 to 25 days at 35 ⁇ 2°C. These were stock cultures and were stored in the refrigerator at 3 ⁇ 2°C for use in a test. A broth culture was mixed on a vortex mixer and homogenized in a 40 ml tissue homogenizer using 5 to 10 strokes. One (1) part heat-inactivated calf serum was added to 19 parts of culture (a final concentration of 5% (v/v)).
• the dilutions were filtered through 0.45 ⁇ m membrane filters and rinsed with approximately 50 ml of sterile deionized water (SDIW).
• SDIW sterile deionized water
• the filters were placed onto M7H9 agar in petri plates. The plates were incubated for 3-4 weeks at 35 ⁇ 2°C inverted in an air-vented autoclave bag to minimize water evaporation and drying of plates during the long incubation period.
• M. bovis var . BCG colonies were counted and multiplied by the appropriate dilution factor to determine the number of colony forming units (CFU) in the reaction flask at various time points (S).
• Cidex® Solution diluted to 1.5% glutaraldehyde was tested against M. bovis var . BCG using exposure times of 5, 10, 20, and 30 minutes at 25 ⁇ 1°C. The entire test was repeated.
• test-strength disinfectant Two serial ten-fold dilutions of test-strength disinfectant were made as 1.0 ml into 9 ml of neutralizing recovery medium. Each dilution tube was spiked with about 200 CFU of M. bovis var . BCG held in 1.0 ml of recovery broth. After 10 minutes at ambient temperature, the dilutions were filtered through 0.45 ⁇ m membrane filters and rinsed with about 50 ml of SDIW. The filters were placed onto M7H9 agar in petri plates.
• the test culture was assayed to determine the original number of CFU in the reaction flask.
• Five (5.0) ml of M. bovis var . BCG were added to 45 ml of SDIW and swirled to mix.
• One (1.0) ml was removed and serial ten-fold dilutions were made into 9 ml portions of neutralizing recovery medium.
• Three sets of dilutions were made. Dilutions 3 through 6 were filtered through 0.45 ⁇ m membrane filters and rinsed with approximately 50 ml of SDIW.
• the filters were placed onto M7H9 agar in petri plates and incubated for 4 to 5 weeks at 35 ⁇ 2°C in an air-vented autoclave bag.
• the M. bovis var . BCG colonies were counted and multiplied by the appropriate dilution factor to determine the number of CFU originally in the reaction flask (So).
• This example shows a test to measure the relative concentrations of glutaraldehyde in the air above (vapors) for various glutaraldehyde (GA) test solutions.
• Equal 1.0 L volumes of 1) 1.0, 2.0, and 2.5% GA in water, 2) 1.0, 2.0, and 2.5% GA plus 25% IPA in water, 3) Cidex® Activated Dialdehyde Solution (2.5% GA), 4) the invention (3.0% GA + 25% IPA plus 8% acetate), and 5) formulation IV (2.5% GA + 20% IPA plus 8% acetate) were placed in the bottom of 5.0 gallon glass jugs.
• the jugs were stoppered, and the stoppers had two different sizes of glass tubes with the longer glass tube connected to an air pump, and the shorter glass tube connected to an airstone in a solution of MBTH.
• Glutaraldehyde vapors released from the formulations of the present invention where alcohol and acetate were present were consistently significantly lower than the Cidex® solution.
• glutaraldehyde vapors released from the formulation that was nominally 3% glutaraldehyde, 25% isopropanol alcohol and 8% potassium acetate and the formulation which was nominally 2.5% glutaraldehyde, 20% isopropanol alcohol and 8% potassium acetate are 65-80% and 78-85% lower than glutaraldehyde vapors released by Cidex® (2.5% glutaraldehyde), respectively.

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• Life Sciences & Earth Sciences (AREA)
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• Organic Low-Molecular-Weight Compounds And Preparation Thereof (AREA)
• Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)

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• 2005
  • 2005-07-11 US US11/178,806 patent/US8658190B2/en active Active
• 2006
  • 2006-06-27 CA CA2614728A patent/CA2614728C/en active Active
  • 2006-06-27 EP EP06774212A patent/EP1903864B1/en not_active Not-in-force
  • 2006-06-27 WO PCT/US2006/025210 patent/WO2007008425A1/en active Application Filing
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  • 2006-06-27 JP JP2008521421A patent/JP4773518B2/ja not_active Expired - Fee Related
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  • 2006-06-27 AT AT06774212T patent/ATE465634T1/de active
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